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Physicians Should Be Aware of Signs of Burnout

Posted on Tue, Mar 31, 2015
Physicians Should Be Aware of Signs of Burnout

Stress is major predictor for burnout among doctors; operating in high-stress environment also harmful

THURSDAY, March 26, 2015 (HealthDay News) -- Burnout can be prevented if physicians are aware of the warning signs, according to an article published by the American Medical Association.

Noting that many physicians are feeling exhausted from practicing medicine, Mark Linzer, M.D., from the Hennepin County Medical Center in Minneapolis, discusses seven signs that physicians should look out for and not ignore.

According to the article, stress is the number one predictor for burnout among physicians; physicians consistently operating under high stress are more than 15 times more likely to burn out. Operating in a high-stress or chaotic environment is also harmful. Physicians who do not agree with their boss' values or leadership are more likely to feel less motivated and subsequently burn out. Physicians frequently act as an emotional buffer, buffering patients from a stressful environment until they can't cope. Spending time with family helps physicians perform better; work-life interference is one of the most common predictors for physician burnout. Lacking control over work schedule and free time can cause stress and spark burnout; setting a standardized set of hours is beneficial for physicians. Finally, neglecting oneself is a sign of burnout; self-care is important in caring for patients.

"People always want to say that physician wellness and performance measures will cost a lot of money, but preventing burnout can actually save money in the long run on recruiting and training new practice staff," Linzer said in a statement.

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Innovative Prototype Presented for Post-ICU Patients

Posted on Mon, Mar 30, 2015
Innovative Prototype Presented for Post-ICU Patients

Collaborative care model can maximize cognitive, physical, psychological recovery of ICU survivors

FRIDAY, March 27, 2015 (HealthDay News) -- A collaborative care model, the Critical Care Recovery Center (CCRC), represents an innovative prototype aimed to improve the quality of life of intensive care unit (ICU) survivors, according to a report published in the March issue of the American Journal of Nursing.

Babar A. Khan, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues discuss the development and implementation of a collaborative care model, the CCRC, which opened in 2011 and aims to maximize the cognitive, physical, and psychological recovery of ICU survivors.

The researchers note that the CCRC was developed around the principles of implementation and complexity science, with a secondary focus on research. Care was provided through a pre-CCRC assessment of patient and caregiver needs; an initial diagnostic work-up visit; and a follow-up visit, including a family conference. During the initial assessment, the CCRC team formulates and implements an individualized care plan. During the follow-up phase, the patient's care plan is monitored and modified based on feedback relating to patient progress.

"Our preliminary data and experience with the CCRC suggest that a collaborative, interdisciplinary care model can enhance the cognitive, physical, and psychological recovery of ICU survivors," the authors write. "The CCRC represents a prototype in the United States for providing post-ICU care to patients who present with post-intensive care syndrome."

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Susac Syndrome Is Possibility in Cases of Acute Confusion

Posted on Thu, Mar 19, 2015
Susac Syndrome Is Possibility in Cases of Acute Confusion

Two cases demonstrate possibility of Susac syndrome for young patients presenting with confusion

TUESDAY, March 10, 2015 (HealthDay News) -- For young patients presenting with acute confusion, Susac syndrome should be considered, according to a case report published online Feb. 10 in the Journal of Stroke & Cerebrovascular Diseases.

Michael Star, M.D., from the Loyola University Chicago Stritch School of Medicine, and colleagues described the clinical course, investigations, management, and follow-up of two patients presenting with acute confusion and abnormal neuroimaging and cerebrospinal fluid (CSF) findings, who were initially misdiagnosed.

The researchers describe a 57-year-old woman with acute onset of confusion, who was initially thought to have multiple strokes. Restricted diffusion involving the splenium of the corpus callosum was demonstrated on magnetic resonance imaging (MRI) and elevated protein levels were seen in CSF. Asymmetric bilateral sensorineural hearing loss (SNHL) was seen on audiometry. Multiple bilateral branch retinal artery occlusions (BRAOs) were seen on fluorescein angiography. The patient was treated with corticosteroids and intravenous immunoglobulin (IVIG); her confusion had resolved at one-month follow-up. The second case involved a 32-year-old man with acute onset confusion. Pleocytosis and elevated protein were seen in CSF. Restricted diffusion involving the corpus callosum was seen on MRI. After presentation for a third time, the patient was found to have bilateral BRAOs and bilateral SNHL. He received IVIG and demonstrated resolution of confusion at one-month follow-up.

"Susac syndrome should be considered in young patients with otherwise unexplained acute onset of confusion with MRI and CSF changes as described previously," the authors write.

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Documentation Tip of the Week: Heart Failure

Posted on Wed, Mar 18, 2015
Documentation Tip of the Week: Heart Failure

Heart Failure Documentation

Coding Clinic (a published guideline for coders) determined that

  • “Heart Failure with reduced Ejection Fraction” CANNOT be coded as “Systolic Heart Failure” AND
 
  • Heart Failure with preserved Ejection Fraction” CANNOT be coded as “Diastolic Heart Failure”

Documentation Awareness:
  • Physicians MUST at some point in the chart document systolic or diastolic to capture the specificity of heart failure correctly
 
  • Remember:  “Acute”, “chronic” or “acute on chronic” must also be documented

Timothy N. Brundage, M.D., CCDs is a Certified Clinical Documentation Specialist and Diplomate of the American Board of Internal Medicine.

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